I have been working in my hospital for 7 years. The first time I
identified ankyloglossia and brought it to the attention of the
attending doctor, he said that without evidence based research, he
would not agree to frenotomy. I brought him all the JHL articles, but
JHL was not a high enough impact journal for him. Luckily, the Messner
work had (2) just come out, and I brought that. He agreed, and decided
to do an additional study to rule out the placebo affect. As soon as
that study is published, I will let you know.
All staff were informed about this problem, and taught to identify it.
Any case of ankyloglossia is referred to me. I have to assess if it is
a breastfeeding problem, either one of milk transfer or a cause of
nipple pain or trauma. If it is, I make a referral to one of the docs
who does the frenotomy, either the head of the dept or our pediatric
dentist. The procedure is usually done the same day. We now take
referrals from all over the country since this is the only place where
frenotomy is done on newborns or infants less than one year of age.
I have to say that in most of the cases that I have seen, the frenotomy
makes a huge difference.
IN some of the cases that were referred, we manage to reduce the pain
level by correcting the latch, but in most cases I recommend frenotomy.
For all of you working in hospitals, I suggest that you keep a special
file of articles to pull out of your hat for such instances, and there
are a must:
.1. Ankyloglossia: Assessment, Incidence, and Effect of Frenuloplasty
on the Breastfeeding Dyad Ballard, Auer, and Khoury PEDIATRICS Vol.
110 No. 5 November 2002, pp. e63
2. Ankyloglossia: incidence and associated feeding difficulties.
Messner et. al.
Arch Otolaryngol Head Neck Surg. 2000 Jan;126(1):36-9.
3. Ankyloglossia: does it matter? Messner et al
Pediatr Clin North Am. 2003 Apr;50(2):381-97. Review
Esther Grunis, IBCLC
Lis Maternity Hospital
Tel Aviv, Israel
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